Arthroscopic Hip Surgery

Arthroscopic hip surgery is usually done on an outpatient basis. Occasionally an overnight stay is recommended depending on the extent of your procedure. Your hospital or surgery center will contact you about the specific details for your surgery, but usually you will be asked to arrive at the hospital an hour or two prior to your surgery.

Do not eat or drink anything after midnight the night before your surgery. Stop taking anti-inflammatories, including aspirin, ibuprofen (Motrin® or Advil®) and Naprosyn® (Aleve®) 10 days before your operation. Tylenol® is fine to take as recommended on the bottle for pain as needed.

After arrival, you will be evaluated by a member of the anesthesia team. Arthroscopy can be performed under regional or general anesthesia. Regional anesthesia numbs you below your waist, and general anesthesia puts you to sleep. The anesthesiologist and surgeon will help you determine which would be the best for you. Most patients choose a short general anesthetic unless they have medical problems which make this form of anesthesia contraindicated.

After you are asleep in the operating room Dr. Peter Gambacorta will have to place your legs under traction in order to access your hip joint. A few small incisions will be placed in your hip. A sterile solution will be used to fill the hip joint and rinse away any cloudy fluid, providing a clear view of your hip.

Dr. Gambacorta will then insert the arthroscope to properly diagnose your problem, using the TV image to guide the arthroscope. If surgical treatment is needed, the surgeon can use a variety of small surgical instruments (e.g. scissors, clamps, motorized shavers and burrs) through another small incision to remove or repair any torn or damaged cartilage.

In addition, Dr. Gambacorta can also re-contour the boney abnormalities including over-coverage of the cup (acetabulum) and bump on the ball (femur), remove any loose pieces of cartilage or bone that may be causing symptoms, release scar tissue, and treat some cartilage problems with microfracture surgery. This part of the procedure usually lasts 1 to 2 hours.

At the conclusion of your surgery, Dr. Gambacorta will close your incisions with sutures and cover them with a bandage. You will be moved to the recovery room. Usually, you will be ready to go home in one or two hours. You should have someone with you to drive you home.

Your Recovery at Home

Recovery from hip arthroscopy is much faster than recovery from traditional open hip surgery. Still, it is important to follow Dr. Gambacorta’s instructions carefully after you return home. You should ask someone to check on you that evening.

Swelling

Keep your leg elevated as much as possible for the first few days after surgery. Apply ice or use the polar care unit as recommended by Dr. Gambacorta to relieve swelling and pain.

Dressing Care

You will leave the hospital with a dressing covering your hip. You may remove the dressing the 2nd day after surgery unless otherwise directed. You may shower, but should avoid directing water at the incisions. Do not soak in a bath, swimming pool or hot tub. After your shower thoroughly pat dry the incision site and apply band aids. Keep your incisions clean and dry. If a brace was applied after surgery, instructions concerning range of motion restrictions and care will be discussed after surgery. Dr. Gambacorta will see you in the office 10 to 14 days after surgery to check your progress, review the surgical findings, and begin your postoperative treatment program.

Bearing Weight

After arthroscopic hip surgery, weight-bearing restrictions and crutch use will vary depending on what procedure was performed. Restrictions may range from:

Non weight bearing (no weight on leg)

Toe touch weight bearing (gentle touch with ball of foot on ground)

Partial weight bearing (25-50% of weight can be safely applied)

Weight bearing as tolerated (full weight bearing)

This information will be written down and discussed with you after surgery.

Exercises to Strengthen Your Hip

Initially after surgery, gentle hip motion is allowed and you will be instructed on what exercises are appropriate after surgery. Positions of deep hip flexion and rotating out (external rotation) should be avoided for six weeks. Dr. Gambacorta will give you a detailed prescription for physical therapy at your first follow-up appointment. You should exercise your hip regularly for several weeks following surgery to strengthen the muscles of your leg and hip.

Medications

Dr. Gambacorta will prescribe pain medication to help relieve discomfort following your surgery. You may need the pain and anti-spasm medication the most during the first two to five days after surgery, and after that, you should be able to begin to taper off the medication. A prescription strength anti-inflammatory medicine will also be prescribed and should be taken as directed for at least two weeks after surgery.

Complications

Potential postoperative problems with hip arthroscopy include infection, bleeding, blood clots, injury to nerve or blood vessel. These occur infrequently and are typically treatable. You may experience some numbness in your groin, thigh or on top of your feet after surgery. Typically this resolves over time, but a small area of numbness can be permanent. There is also a risk of extra bone formation in your hip; taking the anti-inflammatory medicine helps prevent this problem. There is a very small risk of fluid leaking into your abdomen, hip fracture or dislocation.

Warning Signs

Call Dr. Gambacorta, or the orthopedic surgeon on call, immediately if you experience any of the following:

Fever

Chills

Persistent warmth or redness around the hip

Persistent or increased pain

Significant swelling in your hip

Shortness of breath or chest pain

Reasonable Expectations After Surgery

Although arthroscopy can be used to treat many problems, you may have some activity limitations even after recovery. The outcome of your surgery will often be determined by the degree of injury or damage found in your hip.

For example, if you damage your hip from jogging and the smooth articular cushion of the weight-bearing portion of the hip has worn away completely, then full recovery may not be possible. You may be advised to find a low-impact alternative form of exercise. An intercollegiate or professional athlete often sustains the same injury as a weekend recreational athlete, but the potential for recovery may be improved by the over-development of hip muscles.

Physical exercise and rehabilitation will play an important role in your final outcome. A formal physical therapy program also may add something to your final result.

A return to intense physical activity should only be done under the direction of your surgeon. It is reasonable to expect that by four to six months you should be able to engage in most of your former physical activities. This will be dependent on how fast your body can heal.

If you are a student, you will likely be able to return to school about one week after your surgery. If your job involves heavy work, such as a construction laborer, you may require more time to return to your job than if you have a sedentary job.

This information is intended for education of the reader about medical conditions and current treatments. It is not a substitute for examination, diagnosis and care provided by your physician or a licensed healthcare provider. If you believe that you, your child, or someone you know has the condition described above, please see your healthcare provider. Do not attempt to treat yourself or anyone else without proper medical attention.